'Working on a men’s psychiatric ward drove me to the brink'

Camara McKenzie, 24, is a mental health nurse. Here she vividly explains what it was like to work on a men’s acute mental health ward in Birmingham and how it affected her.

It was 6am. I’d been working solidly for 11 hours. The night had gone smoothly and, for a change, I was ready to end my shift on a high.

There was a patient who had been getting progressively more unwell over the week. As the sun was rising, he started to act more and more aggressively. First he took a metal bin and started incessantly bashing it against the wall. He’d become convinced I was on the phone to members of his family. He started shouting at me, then at the rest of the staff. It began to get frightening. He was violent and within minutes had become out of control. I was 23, newly qualified but because of staffing shortages, had been put in charge.

It was my responsibility not just to take care of him but to make sure he didn’t harm the three other staff members and the 16 other patients on the ward. Restraining him felt like an impossible task. I rushed off to sound the alarm, hoping I’d get back-up – but it was a distraction I couldn’t afford. I returned within minutes to find one of the healthcare assistants had been punched in the face. I dragged him away from my colleague, spraining my arm in the process.

Somehow I managed to sleep when I got home but when I came in the next day I couldn’t stop crying and shaking with anxiety. I was frightened. Frightened of seeing this man again. Frightened that something else might spiral out of my control.

Wanting to help

But this, I discovered, was normal. People were often aggressive. I was told to f*** off, called a bitch. Most of the time, I shrugged it off. I’d learnt to give these men grace. I saw that they were unwell and that they didn’t mean it.

I’d been there myself. My journey into mental health nurse nursing was fuelled by a desire to make a difference. I wanted to be someone who listens without judgement because I know firsthand how tough it can be to deal with your own emotions.

When I was a teenager, I grappled with low mood, and it felt like nobody really got it. I’ll never forget when one doctor said to me, "When you’re 16, sometimes you get a bit sad." For me, it was more than just feeling a ‘bit sad’. I knew it wasn’t normal to think about harming yourself or to cry every night.

So, I went to university determined to get to the crux of these issues and join a new generation of nurses committed to understanding and helping people who were struggling mentally.

Facing violence

Studying to become a mental health nurse thrusts you in the deep end. There’s no wonder it has a 50% drop-out rate. It’s not just emotionally taxing – it’s a relentless juggling act of lectures, placements and maintaining some semblance of a social life. Placements are where the real learning happens, but they also disrupt any hopes of a typical university experience. By the final year, you’re essentially taking on the role of a real nurse, shouldering the weight of real-world responsibilities.

Even so, I doubt I could’ve ever been prepared for the reality of what it would be like once I was qualified. You’re trained in how to restrain people, but that’s always within a controlled setting. When faced with patients in crisis, safety and control fly out the window, and you’re left in a fight-or-flight state, acting on pure instinct.

Like the time when the alarm blared and I dashed into the next door ward to find a patient headlocking another. Fear gripped me as we struggled to free the victim, outnumbered and overpowered. With just four women against this aggression, we fought a losing battle, praying for a resolution before he passed out or worse, died.

Drugs and mental illness

Sometimes it got to me. I would be doing everything I could to help this person and it didn't seem like they appreciated it or wanted my help.

The last thing I wanted was to be a teacher to grown men. I had to maintain boundaries, making sure that despite being unwell, they treated me with respect.

The patients were admitted for all sorts of things: depression, personality disorders, psychosis, schizophrenia and bipolar disorder. People tend to think it’s always drug-induced but really it’s a range of things. It can be totally organic or their illness can run in the family.

Of course, drugs were an issue we had to tackle. People would bring them in after going on day leave, stash them in takeaways or even conceal them in their body. We weren’t a prison – it wasn’t our job or our right to deep search.

Black mamba, also known as spice, was a massive problem. The danger with spice is its unpredictability. One patient, addicted to it, faced medical emergencies five times in one day. Vomiting, struggling to breathe, collapsing – it was a relentless cycle until his discharge.

Feeling the pressure

But it wasn’t the moments of panic or aggression or the drugs that drove me away, it was everything else. It was the 13-hour night shifts, with no break. It was barely surviving on four hours of sleep. It was not seeing daylight. It was doing two nurses' jobs in one shift. It was paying for Ubers because I’d overslept for my day shift.

Because there’s such a shortage of NHS beds we got so many inappropriate admissions. Patients who should have been in Psychiatric Intensive Care Units, where there tends to be more staff, were sent to us, where it was sometimes one nurse for 16 patients. It wasn’t safe. Patients who are that unwell can get violent. Staff and other patients were being attacked.

I was overworked. We all were. Dancing was my relief. I’d go out to see friends and not have to worry or I’d sneak to the toilets and film a TikTok dance – just to escape the mental anguish. It sounds odd but I craved my own time so much that after my shift ended, I got into a bad habit of staying up for hours procrastinating rather than getting into bed.

It was the most intense experience of my life. All my money was going on rent and the odd weekend off to see my friends in London. I was incredibly low and I was given therapy by the NHS because of the pressure they could see I was under. Even though my own mental health struggles had made me want to help others, I had to admit I couldn’t cope. After 12 months, I resigned.

A journey of self-discovery

Now four months later, I’m working as a community psychiatric nurse. I’m still living in Birmingham, but my role is to manage medication. This can involve chasing patients when they’ve missed appointments or going to people’s houses to do their injections. I begin at 9am and end at 5pm.

My job has never really made relationships or friendships easy but at least now I get time to read. I have time to go to the gym, cook dinner and prep lunch for the next day.

It’s helped me to figure out my own mental health struggles too. For years I’d been told I have anxiety and depression and only now have I realised that I had neither of things. All these years, I’d been struggling with undiagnosed ADHD, but in 2023 I finally had an assessment and a specialist diagnosed me with ADHD. Therapy is helping, but it's sticking to a routine that makes the real difference.

Don't get me wrong, strangely enough, sometimes I miss the ward. I still go back on the weekends to do the odd shift. What I love about community nursing is that you see people getting better and getting their life back on track. From the patient who initially couldn’t sit still due to overwhelming paranoia to the same individual, seven weeks later, eagerly sharing stories of time spent with friends and family without a hint of fear – I see the power of proper medical treatment and compassionate support.

It’s moments like these that make it worth it. It is what I signed up for: caring for people and helping them to get better. I don’t know if I’ve made a difference yet but I think I’ve made a good start.

Read more

The most common mental health conditions – and where to get help (5-min read, Yahoo Life UK)

OCD made me so scared of the outside world I couldn't leave the house (8-min read, Yahoo Life UK)

Bipolar made me suicidal but now I’ve completely rebuilt my life (7-min read, Yahoo Life UK)